Saturday, April 12, 2014

The dysfunctional for profit US health care system

by Lisa Hane, RN, MSN, PHN

It is hardly news to anyone in the US that our health care delivery system is in crisis.  It is the most dysfunctional health care system in the advanced capitalist world.

This week, front page articles in both the Wall Street Journal and The New York Times showed yet again what happens when profits get mixed up with health care. Data released by the Centers for Medicare and Medicaid Services (CMS) showed that, “The top 1% of 825,000 individual medical providers accounted for 14% of the $77 billion in billing to the government.”

Further, “Medicare paid 344 doctors and other health care providers over $3 million each in 2012. Collectively the 1,000 highest paid Medicare doctors received collectively $3.05 billion in payments”. 

The current system has incentivized health care providers to over-treat patients, pad their bills, and wrongly prescribe medications in order to obtain these salaries. Pharmaceutical companies that manufacture many of the drugs used by these physicians receive hundreds of millions of Medicare dollars each year. A drug called Luncetis, used for the treatment of eye diseases costs $2,000 a shot. Payments to Genetech, the company that makes Lucentis,  accounted for about $1 billion dollars in government spending in 2012 according to the New York Times article.

While most individual doctors are practicing responsibly and not becoming super rich from their work, clearly there are some who are gaming the system and striving to emulate the investment bankers and the other 1% who are only interested in advancing their personal wealth at the expense of the rest of society. This must not continue.

Our health care system needs fundamental change. Sure, the implementation of the Patient Protection and Affordable Care Act also known as “Obama Care” has provided health insurance for many more people than had it previously, but in no way does it deal with the real problem.  Health insurance is not the answer.  Full access to quality health care is. People need the security of knowing that if they get sick or need some medical treatment, it is available to them. Health care should be a right, like public education. The Medicare report clearly shows that health care delivery based on profits for insurance companies, hospital corporations, drug companies and some greedy physicians cannot act in the best interest of people’s health.

We need a national health system available to all regardless of their health status, employment situation, age, or ability to pay, now!

1 comment:

Anonymous said...

I couldn't agree more with the opinion of this very smart "insider"! :-) In my first year of Duke med school, 1966, my class was taught about HMO's such as Kaiser in CA, and Group Health in Seattle, in the course "Family and Community Medicine," which exposed us to the various modes possible then for practicing medicine. "Pre-paid medical care" seemed so beautiful, logical, and just. I assumed back then that by now, 48 years later, pre-paid medicine would be the primary mode of health care delivery in the United States.
Margaret Walker MD, retired Kaiser neonatologist and pediatrician